3-D radiotherapy plan dose-volume histograms (77295)
range across 4 matching MRF lines |
— |
$13,358–$14,413 |
— |
| Abdomen 1 View (74018) |
— |
$764 |
— |
| Abdomen 2 views (74019) |
— |
$935 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,938 |
— |
| Angio internal mammary (75756) |
— |
$4,604 |
— |
Angio pulmonary bilat (75743)
range across 2 matching MRF lines |
— |
$7,258–$7,840 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$7,575 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$5,732 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$6,335 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$3,617 |
— |
Ankle 2 views (73600)
range across 9 matching MRF lines |
— |
$560–$1,018 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$8,731 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$9,081 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$7,224 |
— |
| Artery X-Rays Adrenal Gland (75731) |
— |
$13,635 |
— |
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines |
— |
$5,396–$6,938 |
— |
| Artery X-Rays Spine (75705) |
— |
$7,066 |
— |
| Arthrogram hip (73525) |
— |
$1,122 |
— |
| Arthrogram Wrist (73115) |
— |
$697 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$1,305 |
— |
| Bone age studies (77072) |
— |
$478 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$4,708 |
— |
| Bone Imaging Limited Area (78300) |
— |
$2,080 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$2,481 |
— |
| Bone Imaging Whole Body (78306) |
— |
$4,627 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,892 |
— |
| Bone marrow imaging; multiple areas (78103) |
— |
$1,689 |
— |
| Bone survey infant (77076) |
— |
$1,232 |
— |
| Brachytx isodose complex (77318) |
— |
$3,384 |
— |
| Brachytx isodose intermed (77317) |
— |
$2,492 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$2,131 |
— |
| Brain Flow Imaging Only (78610) |
— |
$1,713 |
— |
| Brain Image W/Flow < 4 Views (78601) |
— |
$2,369 |
— |
| Brain imaging < 4 static views (78600) |
— |
$1,817 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$2,917 |
— |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
— |
$4,246 |
— |
Cardiac MRI w/w/o contrast & further seq (75561)
range across 2 matching MRF lines |
— |
$2,253–$6,002 |
— |
| Cardiac MRI w/w/o contrast w/stress (75563) |
— |
$6,158 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$2,850 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$2,056 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$3,257 |
— |
Chest 1 view (71045)
range across 3 matching MRF lines |
— |
$62–$526 |
— |
Chest 2 views (71046)
range across 2 matching MRF lines |
— |
$74–$674 |
— |
| Chest 3 views (71047) |
— |
$686 |
— |
| Chest 4 or more views (71048) |
— |
$698 |
— |
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883)
range across 2 matching MRF lines |
— |
$1,688–$2,534 |
— |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
— |
$1,020 |
— |
Clavicle complete (73000)
range across 4 matching MRF lines |
— |
$518–$1,168 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$362 |
— |
Continuing medical physics consltj pr wk (77336)
range across 3 matching MRF lines |
— |
$421–$1,458 |
— |
Contrast Exam Abdominl Aorta (75625)
range across 3 matching MRF lines |
— |
$4,119–$6,025 |
— |
Contrast X-Ray Bladder (74430)
range across 4 matching MRF lines |
— |
$1,008–$1,320 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,146 |
— |
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines |
— |
$6,448–$6,706 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$4,651 |
— |
CT abdomen w contrast (74160)
range across 3 matching MRF lines |
— |
$2,744–$8,754 |
— |
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines |
— |
$3,462–$11,048 |
— |
CT abdomen w/o contrast (74150)
range across 2 matching MRF lines |
— |
$2,482–$7,916 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$3,137 |
— |
| CT Angio Chest (71275) |
— |
$2,271 |
— |
CT Angio Head (70496)
range across 2 matching MRF lines |
— |
$1,935–$6,311 |
— |
| CT angio hrt w/3d image (75574) |
— |
$6,931 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$6,183 |
— |
CT Angio Neck (70498)
range across 2 matching MRF lines |
— |
$1,581–$6,778 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$6,968 |
— |
| CT bone density (77078) |
— |
$671 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$7,344 |
— |
CT cervical spine w/o contrast (72125)
range across 4 matching MRF lines |
— |
$3,318–$3,767 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$6,131 |
— |
| CT chest w contrast (71260) |
— |
$3,245 |
— |
| CT chest w/wo contrast (71270) |
— |
$6,647 |
— |
CT colonography screening (74263)
range across 3 matching MRF lines |
— |
$566–$2,719 |
— |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
— |
$2,986 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$2,936 |
— |
| CT head/brain with contrast (70460) |
— |
$5,817 |
— |
| CT head/brain without and with contrast (70470) |
— |
$7,136 |
— |
CT heart contrast eval cardiac structure&morph (75572)
range across 2 matching MRF lines |
— |
$5,103–$5,510 |
— |
CT heart no contrast quant eval coronry calcium (75571)
range across 4 matching MRF lines |
— |
$60–$4,678 |
— |
| CT hrt w/3d image congen (75573) |
— |
$5,558 |
— |
CT iac w contrast (70481)
range across 2 matching MRF lines |
— |
$5,342–$5,768 |
— |
CT l-spine w&w/o contrast (72133)
range across 3 matching MRF lines |
— |
$2,027–$5,992 |
— |
CT lower ext w/o (73700)
range across 6 matching MRF lines |
— |
$1,484–$7,474 |
— |
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines |
— |
$5,979–$8,305 |
— |
CT lumbar spine w contrast (72132)
range across 2 matching MRF lines |
— |
$2,027–$6,469 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,839 |
— |
CT maxillofacial w contrast (70487)
range across 2 matching MRF lines |
— |
$4,107–$5,567 |
— |
CT maxillofacial wo contrast (70486)
range across 3 matching MRF lines |
— |
$3,201–$4,685 |
— |
CT neck tissue combo (70492)
range across 2 matching MRF lines |
— |
$5,114–$5,523 |
— |
Ct Orbit/Ear/Fossa W/O&W/Dye (70482)
range across 2 matching MRF lines |
— |
$4,059–$5,832 |
— |
CT orbits w/o contrast (70480)
range across 2 matching MRF lines |
— |
$4,597–$4,966 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$8,866 |
— |
CT pelvis w/o contrast (72192)
range across 2 matching MRF lines |
— |
$1,728–$5,519 |
— |
CT scan of leg combo (73702)
range across 4 matching MRF lines |
— |
$4,513–$8,492 |
— |
CT scans face/jaw combo (70488)
range across 2 matching MRF lines |
— |
$5,734–$6,193 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,808 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$4,131 |
— |
| CT thoracic spine w contrast (72129) |
— |
$6,643 |
— |
CT thoracic spine w/o contrast (72128)
range across 2 matching MRF lines |
— |
$1,886–$6,016 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$6,439 |
— |
CT thorax w/o contrast (71250)
range across 5 matching MRF lines |
— |
$2,596–$3,185 |
— |
CT unlisted procedure (76497)
range across 2 matching MRF lines |
— |
$266–$4,073 |
— |
CT upper ext wo (73200)
range across 4 matching MRF lines |
— |
$1,515–$7,398 |
— |
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines |
— |
$5,465–$8,197 |
— |
CT upper extremity with contrast (73201)
range across 3 matching MRF lines |
— |
$6,421–$8,920 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$10,132 |
— |
Cta Abdomen (74175)
range across 2 matching MRF lines |
— |
$2,683–$8,560 |
— |
CTA pelvis (72191)
range across 2 matching MRF lines |
— |
$2,274–$7,251 |
— |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
— |
$581 |
— |
| Discography Cerv/Thor Spine (72285) |
— |
$3,439 |
— |
| Diskography lumbar (72295) |
— |
$3,647 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$973 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$1,348 |
— |
| Dxa Bone Density Axial (77080) |
— |
$827 |
— |
| Dxa bone density study (77085) |
— |
$1,047 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$510 |
— |
| Echo exam of fetal heart (76825) |
— |
$2,711 |
— |
| Echo exam uterus (76831) |
— |
$1,500 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$1,738 |
— |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
— |
$1,570 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$1,299 |
— |
| Esophageal Motility Study (78258) |
— |
$1,731 |
— |
| Esophagram (74220) |
— |
$1,151 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,475 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,304 |
— |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
— |
$6,012 |
— |
Fluoroscopy up to 1 hr (76000)
range across 4 matching MRF lines |
— |
$941–$1,116 |
— |
| Follow-Up Angiography (75898) |
— |
$2,726 |
— |
Foot 2 views (73620)
range across 10 matching MRF lines |
— |
$648–$1,176 |
— |
Forearm 2 views (73090)
range across 9 matching MRF lines |
— |
$691–$1,187 |
— |
| Gastric emptying imaging study (78264) |
— |
$3,736 |
— |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
— |
$3,204 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,924 |
— |
| Gated Heart, Multiple (78473) |
— |
$3,950 |
— |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
— |
$6,180 |
— |
Hand 2 views (73120)
range across 6 matching MRF lines |
— |
$684–$1,029 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
— |
$7,728 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
— |
$6,883 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
— |
$5,854 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$7,340 |
— |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
— |
$3,787 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$4,280 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$4,280 |
— |
Ht Musc Image Planar Mult (78454)
range across 2 matching MRF lines |
— |
$4,246–$5,753 |
— |
Ht Muscle Image Spect Sing (78451)
range across 3 matching MRF lines |
— |
$5,302–$7,183 |
— |
| Hysterosalpingogram (74740) |
— |
$1,326 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$7,845 |
— |
| Joint Survey Single View (77077) |
— |
$428 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$4,028 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$4,332 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$4,096 |
— |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
— |
$2,947 |
— |
Knee 3 Views (73562)
range across 4 matching MRF lines |
— |
$757–$1,358 |
— |
| Leveen/Shunt Patency Exam (78291) |
— |
$2,212 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$2,670 |
— |
| Liver imaging static only (78201) |
— |
$2,485 |
— |
| Liver imaging w/vascular flow (78202) |
— |
$2,997 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$4,573 |
— |
| Lung perfusion differential (78597) |
— |
$3,503 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$4,573 |
— |
| Lung Ventilation Imaging (78579) |
— |
$2,503 |
— |
| Lymph System Imaging (78195) |
— |
$3,102 |
— |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
— |
$3,480 |
— |
| Lymphangiography extremity only unilateral rs&i (75801) |
— |
$1,686 |
— |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
— |
$3,351 |
— |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
— |
$4,153 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$4,026 |
— |
| Magnetic Resonance Elastography (76391) |
— |
$7,850 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$1,125 |
— |
Mammary ductogram or galactogram single (77053)
range across 2 matching MRF lines |
— |
$905–$978 |
— |
| Meckels Divert Exam (78290) |
— |
$923 |
— |
Mlc imrt design & construction per imrt plan (77338)
range across 2 matching MRF lines |
— |
$1,375–$2,202 |
— |
Mra Head W/O & W/Contrast Material (70546)
range across 2 matching MRF lines |
— |
$1,789–$7,015 |
— |
MRA head w/o contrast (70544)
range across 3 matching MRF lines |
— |
$655–$2,380 |
— |
| MRA head with contrast (70545) |
— |
$5,184 |
— |
| MRA neck w contrast (70548) |
— |
$5,172 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$3,028 |
— |
| MRA neck w/o contrast (70547) |
— |
$4,858 |
— |
| MRI abdomen w contrast (74182) |
— |
$6,350 |
— |
MRI abdomen w/o contrast (74181)
range across 4 matching MRF lines |
— |
$882–$7,850 |
— |
MRI any jt lower extrem w/contrast material (73722)
range across 5 matching MRF lines |
— |
$8,013–$12,019 |
— |
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 6 matching MRF lines |
— |
$8,651–$12,974 |
— |
MRI any jt upper extremity w/contrast matrl (73222)
range across 5 matching MRF lines |
— |
$6,568–$9,850 |
— |
| MRI brain functional w/o physician admnistration (70554) |
— |
$5,325 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$7,518 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$5,011 |
— |
| MRI cardiac w/o cont stress (75559) |
— |
$6,110 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$3,740 |
— |
| MRI cervical spine w contrast (72142) |
— |
$8,148 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$3,894 |
— |
| MRI chest w/o contrast (71550) |
— |
$6,854 |
— |
| MRI chest with contrast (71551) |
— |
$5,509 |
— |
| MRI chest wo w contrast (71552) |
— |
$10,255 |
— |
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 5 matching MRF lines |
— |
$5,453–$8,179 |
— |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 6 matching MRF lines |
— |
$7,756–$17,106 |
— |
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 7 matching MRF lines |
— |
$2,153–$10,763 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$8,627 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$10,567 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$8,507 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$3,789 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$8,507 |
— |
| MRI pelvis w contrast (72196) |
— |
$5,681 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$10,567 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$3,461 |
— |
MRI spectroscopy (76390)
range across 2 matching MRF lines |
— |
$3,808–$5,039 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,786 |
— |
MRI upper extremity oth than jt w/contr matrl (73219)
range across 4 matching MRF lines |
— |
$5,509–$8,265 |
— |
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 8 matching MRF lines |
— |
$2,085–$9,238 |
— |
Mri Uppr Extremity W/O&W/Dye (73220)
range across 6 matching MRF lines |
— |
$7,679–$11,517 |
— |
| MRI, abdomen, combo (74183) |
— |
$4,543 |
— |
MRI, dorsal spine combo (72157)
range across 2 matching MRF lines |
— |
$9,785–$10,567 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$9,035 |
— |
MRI, joint upper extrem (73221)
range across 6 matching MRF lines |
— |
$2,276–$9,246 |
— |
MRI, joint upper extrem combo (73223)
range across 6 matching MRF lines |
— |
$7,808–$11,709 |
— |
| MRI, lumbar spine combo (72158) |
— |
$5,624 |
— |
| Myelogram cervical (72240) |
— |
$2,336 |
— |
| Myelogram Lumbar (72265) |
— |
$2,099 |
— |
| Myelography thoracic (72255) |
— |
$1,920 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$2,299 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$2,574 |
— |
Myocardial Perfusion Planar 1 Study Rest/Stress (78453)
range across 2 matching MRF lines |
— |
$3,812–$4,612 |
— |
Myocardial Spect Multiple Studies (78452)
range across 3 matching MRF lines |
— |
$2,392–$2,488 |
— |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
— |
$9,807 |
— |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
— |
$6,051 |
— |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
— |
$6,051 |
— |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
— |
$6,051 |
— |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
— |
$6,051 |
— |
N-invas est c ffr sw aly CTA (75580)
range across 2 matching MRF lines |
— |
$3,335–$4,702 |
— |
| Neck soft tissue (70360) |
— |
$649 |
— |
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808)
range across 2 matching MRF lines |
— |
$402–$1,034 |
— |
| Nm csf leak detection (78650) |
— |
$2,383 |
— |
| Nonvascular Shunt X-Ray (75809) |
— |
$1,037 |
— |
Ntsty modul radthx pln dose-vol histos (77301)
range across 3 matching MRF lines |
— |
$7,875–$11,395 |
— |
| Nuclear Rx Intra-Arterial (79445) |
— |
$2,717 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$3,117 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$712 |
— |
| Ophthalmic us dx quantitative a-scan only (76511) |
— |
$731 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$509 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$4,409 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$3,237 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$3,236 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$695 |
— |
| Perineogram (74775) |
— |
$1,711 |
— |
| Peritoneogram Rs&I (74190) |
— |
$1,279 |
— |
| Proton tx delivery complex (77525) |
— |
$11,447 |
— |
| Proton tx delivery intermediate (77523) |
— |
$6,603 |
— |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
— |
$2,955 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$2,605 |
— |
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022)
range across 2 matching MRF lines |
— |
$1,108–$1,196 |
— |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 3 matching MRF lines |
— |
$968–$1,130 |
— |
Radex Ankle Complete Minimum 3 Views (73610)
range across 7 matching MRF lines |
— |
$667–$1,264 |
— |
Radex Calcaneus Minimum 2 Views (73650)
range across 4 matching MRF lines |
— |
$590–$965 |
— |
Radex elbow complete minimum 3 views (73080)
range across 6 matching MRF lines |
— |
$670–$1,373 |
— |
Radex Facial Bones Complete Minimum 3 Views (70150)
range across 2 matching MRF lines |
— |
$736–$794 |
— |
Radex fingr minimum 2 views (73140)
range across 15 matching MRF lines |
— |
$532–$574 |
— |
Radex foot complete minimum 3 views (73630)
range across 6 matching MRF lines |
— |
$793–$1,268 |
— |
Radex Hand Minimum 3 Views (73130)
range across 4 matching MRF lines |
— |
$739–$1,192 |
— |
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines |
— |
$168–$330 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$641 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$760 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$742 |
— |
Radex shoulder complete minimum 2 views (73030)
range across 5 matching MRF lines |
— |
$783–$1,358 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$560 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$569 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$739 |
— |
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330)
range across 2 matching MRF lines |
— |
$596–$645 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$499 |
— |
Radex upper extremity infant minimum 2 views (73092)
range across 5 matching MRF lines |
— |
$438–$656 |
— |
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines |
— |
$723–$1,003 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$668 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$65,401 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$1,332 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$1,005 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$2,047 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$878 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$1,107 |
— |
Radiologic exam colon double contrast study (74280)
range across 2 matching MRF lines |
— |
$1,944–$2,102 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,726 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$1,273 |
— |
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines |
— |
$811–$1,482 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$861 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$1,591 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$1,162 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,936 |
— |
Radiologic examination femur 1 view (73551)
range across 4 matching MRF lines |
— |
$489–$734 |
— |
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines |
— |
$530–$1,056 |
— |
Radiologic examination knee 1/2 views (73560)
range across 8 matching MRF lines |
— |
$680–$1,085 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$713 |
— |
Radiologic examination tibia & fibula 2 views (73590)
range across 6 matching MRF lines |
— |
$730–$1,089 |
— |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
— |
$641 |
— |
| Radiologic examination, teeth; single view Non-Facility (70300) |
— |
$222 |
— |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
— |
$1,373 |
— |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
— |
$2,810 |
— |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
— |
$4,380 |
— |
| Ribs bilateral 3 views (71110) |
— |
$918 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$3,428 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$3,497 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$5,767 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$4,994 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$6,516 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$3,907 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$4,433 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$3,907 |
— |
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403)
range across 2 matching MRF lines |
— |
$2,785–$3,064 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$2,628 |
— |
Scapula (73010)
range across 3 matching MRF lines |
— |
$737–$1,288 |
— |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines |
— |
$161–$475 |
— |
Shoulder 1 view (73020)
range across 3 matching MRF lines |
— |
$642–$1,190 |
— |
| Shoulder Arthrography (73040) |
— |
$932 |
— |
| Skull less than 4 views (70250) |
— |
$857 |
— |
| Special dosimetry (77331) |
— |
$1,488 |
— |
| Special Physics Consult (77370) |
— |
$1,835 |
— |
| Special teletherapy port plan (77321) |
— |
$2,428 |
— |
| Special treatment procedure (77470) |
— |
$3,480 |
— |
| Srs Multisource (77371) |
— |
$59,476 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$17,162 |
— |
| Sternoclavicular joints (71130) |
— |
$739 |
— |
| Superior sagittal sinus venogram (75870) |
— |
$3,191 |
— |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
— |
$721 |
— |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
— |
$426 |
— |
| Tbs technical calculation only (77091) |
— |
$426 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$3,376 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$1,489 |
— |
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines |
— |
$3,440–$4,449 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$2,195 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,869 |
— |
| Thoracic spine 2 views (72070) |
— |
$881 |
— |
| Thoracic spine 3 views (72072) |
— |
$949 |
— |
| Thoracolumbar 2 views (72080) |
— |
$976 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,538 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$3,432 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$1,527 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$3,365 |
— |
Tx Devices Design & Construction Complex (77334)
range across 4 matching MRF lines |
— |
$2,134–$2,943 |
— |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
— |
$1,228–$1,486 |
— |
Tx devices design & construction simple (77332)
range across 2 matching MRF lines |
— |
$1,056–$1,277 |
— |
Ultrasound Breast Limited (76642)
range across 5 matching MRF lines |
— |
$1,005–$1,841 |
— |
| Ultrasound elastography first target lesion (76982) |
— |
$1,228 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$1,228 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$890 |
— |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
— |
$1,228 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$624 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$713 |
— |
Unlisted fluoroscopic procedure (76496)
range across 2 matching MRF lines |
— |
$164–$1,051 |
— |
| Unlisted Procedure Clinical Brachytherapy (77799) |
— |
$7,002 |
— |
Unlisted us procedure (76999)
range across 7 matching MRF lines |
— |
$631–$898 |
— |
| Upper gi w/o kub (74240) |
— |
$1,511 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,469 |
— |
| Urethrocystography retrograde (74450) |
— |
$1,162 |
— |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
— |
$1,228–$1,841 |
— |
Us chest (76604)
range across 2 matching MRF lines |
— |
$949–$998 |
— |
| Us complete joint (76881) |
— |
$1,688 |
— |
Us exam, pelvic, limited (76857)
range across 4 matching MRF lines |
— |
$831–$1,414 |
— |
| Us head (76506) |
— |
$1,162 |
— |
Us kidney transplant (76776)
range across 2 matching MRF lines |
— |
$1,527–$1,651 |
— |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 3 matching MRF lines |
— |
$1,232–$1,329 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$935 |
— |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
— |
$1,007–$1,088 |
— |
| Us pelvic non ob complete (76856) |
— |
$865 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,544 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$244 |
— |
Us retroperitoneal complete (76770)
range across 2 matching MRF lines |
— |
$1,585–$1,712 |
— |
| Us retroperitoneal limited (76775) |
— |
$757 |
— |
Us scrotum and contents (76870)
range across 2 matching MRF lines |
— |
$1,251–$1,350 |
— |
Us thyroid (76536)
range across 2 matching MRF lines |
— |
$1,267–$1,369 |
— |
| Us transrectal (76872) |
— |
$1,553 |
— |
| Vein X-Ray Chest (75827) |
— |
$4,902 |
— |
| Vein X-Ray Liver W/O Hemodyn (75887) |
— |
$4,472 |
— |
| Vein X-Ray Spleen/Liver (75810) |
— |
$5,984 |
— |
| Venogram Sinus/Jugular (75860) |
— |
$3,608 |
— |
| Venography Adrenal Unilateral (75840) |
— |
$6,391 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$4,824 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$3,301 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$2,661 |
— |
| Venography Orbital Rs&I (75880) |
— |
$2,224 |
— |
| Venography Renal Bilateral (75833) |
— |
$5,738 |
— |
| Venography Renal Unilateral (75831) |
— |
$5,433 |
— |
| Venous sampling by catheter (75893) |
— |
$5,148 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$489 |
— |
Wrist 2 views (73100)
range across 7 matching MRF lines |
— |
$542–$1,157 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$680 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,314 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$7,355 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$1,060 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 9 matching MRF lines |
— |
$592–$1,095 |
— |
X-Ray Exam Breast Specimen (76098)
range across 3 matching MRF lines |
— |
$928–$1,002 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$668 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$721 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$656 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$530 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$508 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$1,034 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$862 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$1,459 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,459 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,318 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$793 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,194 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$897 |
— |
| X-ray head for orthodontia (70350) |
— |
$385 |
— |
X-ray humerus (73060)
range across 7 matching MRF lines |
— |
$308–$1,202 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,573 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$1,741 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$654 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$720 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$930 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$759 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$462 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$732 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$996 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$1,132 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$767 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$516 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,728 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$719 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,792 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$1,031 |
— |
Xr facial bones less than 3 views (70140)
range across 2 matching MRF lines |
— |
$472–$510 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$433 |
— |
| Xr orbits complete 4 views (70200) |
— |
$786 |
— |